Welcome to my blog, discover acupuncture with Dr Maggie Ju

Qualified as a medical doctor in Western medicine in China with a Medical degree from Beijing, China and a PhD degree from the UK. Many year research and clinical experiences. This blog is for information only.

Wednesday, 6 July 2022

Men also get pelvic pain, do you know acupuncture can help?

Prostatitis is a condition in which the prostate gland is inflamed. It can be acute or chronic and it also can be infective and non-infective. Chronic nonbacterial prostatitis is most common. It happens to about 20% men. About 90% men with chronic prostatitis have chronic prostatitis/chronic pelvic pain syndrome(CPPS). Chronic bacterial prostatitis is much less compared with chronic prostatitis/CPPS. The main symptom is pelvic and perineal pain lasting longer than 3 month. Pain can be in the perineum, testicles, tip of penis, pubic or bladder area and may spread out to the back and rectum. Post ejaculatory pain may be present. The cause of CP/CPPs is not clear, but it may be related to hormonal changes, autonomic nervous system imbalance , abnormal local or systemic inflammation, altered immune function and genetic factors. Stress could be a contributing factor for CP/CPPS. The treatments can be challenging with limited success.

How to treat this condition remains challenging. Acupuncture treatment for CP/CPPS is effective.
Capodice JL et al in USA investigated the effect of acupuncture on CP/CPPS. There were 10 men aged between 18-65 participated the study. They have been diagnosed with chronic prostatitis for greater 6 months, had at least 1 conventional therapy antibiotics, anti-inflammatory agents, 5-α reductase inhibitors or α-1 blockers), scoring >4 on the pain subset of the NIH-CPSI which was used to assess the severity of the CP/CPPS. After 3 weeks, 6 weeks of acupuncture treatment and 6 weeks of followup the NIH-CPSI scores were significantly decreased. Pain and urinary symptoms and quality of life were also significantly improved. No side effects were reported. They suggested that acupuncture cold be the effective treatment option for patients with CP/CPPS.

A case report: Acupuncture and TCM for the treatment of a 35 year old man with chronic prostatitis with chronic pelvic pain syndrome. A 35 year old man had chronic prostatitis with chronic pelvic pain syndrome. This man’s symptoms are very severe. He had 38 out of 43 scores on the NIH?CPSI which is the National Institutes of Health/Chronic Prostatis Symptom In dex. The Index is used for rating pain, urinary symptoms and quality of life impact. He also had experienced recurrent episodes of nonbacterial prostatitis over 3 years. This patient was given 8 acupuncture treatments over 8 weeks and plus some herb medicine Ba Zheng San and Yi Guan Jian daily. His symptoms scored 9 on the NIH/CPSI. After this he was advised to drink green tea. 4 months later his symptoms scored 4; 8 month later scored 2; and 1 year later scored 0. This patient had long term relief from chronic prostatitis with chronic pelvic pain syndrome benefited from 8 sessions of acupuncture treatments and herbs. This suggested acupuncture and herb medicine could be a treatment option for chronic prostatitis and chronic pelvic pain syndrome.

Recent review has found the acupuncture reduces pain of non bacterial chronic prostatitis. In this study, non-pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome was analysed. Data from 3290 men with CP/CPPS were collected and analysed. Acupuncture was found to reduce CP/CPPS pain effectively with few side effects.

Why can acupuncture be used to treat chronic prostatitis/CPPS?
Acupuncture has been proved in effectively treating chronic prostatitis/CPPS. The mechanisms are also studied in current research to provide scientific evidence for the treatment and it is suggested that acupuncture reduces local inflammation and improves local microcirculation. Acupuncture was seen to increase immunoglobulin A in the prostatic fluids and improve local immune function of the prostate. It was also seen that interleukin-2 and testosterone, tumor necrosis factor-α (TNF-α) and the expression of intercellular adhesion molecule 1 (ICAM-1) were altered which were involved in inflammatory reaction. For example a recent study participated by 47 patients with CP/CPPS. After received acupuncture treatments pain or discomfort score decreased remarkably as compared with that before treatment. The levels of IL-8, IL-10 and TNF-alpha which were inflammatory markers were lower than those before treatment. The positive correlation was obtained between IL-10 level and pain score. They suggested that acupuncture has significant efficacy on CP/CPPS through reducing IL-10 level to ease pain, and reducing the levels of IL-8 and TNF-alpha to relieve inflammatory reaction.

Recently, a small sample clinic trial was conducted to investigate the mechanism of acupuncture underlying the treatment of chronic prostatitis/CPPS. 12 patients participated the study. Immune function tests were performed before and after 10 weeks acupuncture treatment. At the end of study 67% responded the treatments. The acupuncture group averaged a 5% increase in natural killer cell levels compared to control group. Similarly, patients randomized to acupuncture reported a reduction in other white blood cell parameters examined. This study supported the possibility that immunity might be important in the pathophysiology of CP/CPPS and suggested potential mechanism of acupuncture treatment.

References

Yang ZX et al Zhong Xi Yi Jie He Xue Bao (2012) 10:293-7

Capodice JL et al Chin Med (2007) 2:1

Yuan SY et al Zhongguo Zhen Jiu (2011) 31:11-4

Ohlsen BA J Chiropr Med (2013) 12:182-90

Lee SW et al Complement Ther Med (2014) 22:965-9

Franco JV et al Cochrane Database Syst Rev (2018) May 12;5:CD012551. doi: 10.1002/14651858.CD012551.pub3.

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